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Tic Disorders and Stereotypies 

Tic Disorders and Stereotypies
Chapter:
Tic Disorders and Stereotypies
Author(s):

Erika F. Augustine

and Jonathan W. Mink

DOI:
10.1093/med/9780199609536.003.0024
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date: 23 February 2020

Tics and stereotypies are common childhood movement disorders, each characterized by repetitive stereotyped movements. Older age at onset, a fluctuating and evolving course, and the presence of a premonitory urge are all helpful features that help to differentiate tics from stereotypies. Tics are frequently associated with comorbid disorders, including attention deficit–hyperactivity disorder (ADHD), obsessive–compulsive disorder (OCD), anxiety, mood disorders, and behavioural difficulties. These co-occurring neuropsychiatric disorders may be the main source of functional impairment. When tics result in functional impairment, α2-adrenergic agonists and dopamine receptor antagonists are the mainstay of therapy. Stereotypies are commonly found in healthy, typically developing children. Yet, they are also prominent in children with neurodevelopmental disabilities. Stereotypies typically do not require treatment. When part of a more complex neurodevelopmental disorder, behavioural strategies can be beneficial. For both types of involuntary movement, assessment of phenomenology and review of social, emotional, neurobehavioural, and cognitive factors are key to diagnosis as well as further evaluation and treatment.

Tics and stereotypies are among the most common movement disorders in childhood. These early-onset involuntary movements are stereotyped in nature, but differ in phenomenology, age at onset, and comorbid conditions. This chapter will outline the key identifying features, natural history, and treatment of each.

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